Last Sunday, Hilde Lynn Helphenstein was found dead in her hotel room overlooking the lush gardens of the Rosewood in São Paulo, Brazil. She was surrounded by just a few stray objects: an empty vodka bottle, a shattered glass, and prescription-pill bottles. Outside, it was sprinkling rain, and the clouds hung low over the city.

Helphenstein, 40, had undergone a cosmetic procedure three weeks earlier, and was staying in the city to recover. When her surgeon called to check in on her and didn’t hear back, he contacted the hotel staff to get access to her room, where he found her lying lifeless in bed.